Dai Dong-Mei, Wang Dong, Hu Di, Wan Wen-Lei, Su Yu, Yang Ji-Lin, Wang Yu-Ping, Wang Fei, Yang Lei, Sun Hai-Mei, Chen Yuan-Yuan, Fang Xiao, Cao Jing, Luo Jie, Tang Kun, Hu Rui, Duan Hua-Nan, Li Mei, Xu Wang-Bin
Department of Intensive Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Arch Med Sci. 2019 Jul 25;16(3):522-530. doi: 10.5114/aoms.2019.86898. eCollection 2020.
In clinical practice, it has been observed that patients with severe infections show changes to their hematocrit (HCT) and serum albumin (ALB) levels. This study aimed to evaluate whether the difference of HCT and ALB (HCT-ALB) levels can be used as an additional biomarker for fast diagnosis of severe infections.
This was a retrospective case-control study which included adult patients with severe infections, patients with non-infective conditions and healthy individuals. A total of 7,117 individuals were recruited in Yunnan Province, China, from January 2012 to January 2018, and were divided into three groups: 1,033 patients with severe infections (group 1); 1,081 patients with non-infective conditions (group 2); and 5,003 healthy individuals from the general population (group 3). The potential diagnostic threshold of HCT-ALB for severe infectious patients was determined by the receiver operating characteristic (ROC) curve analysis. Group 3 was used as the reference to draw the ROC curves of the HCT-ALB value in group 1 or group 2.
HCT-ALB values in each group were significantly different. We found that the area under the ROC curve (AUC) of group 1 reached 0.87 (95% CI: 0.86-0.89), whereas the AUC of group 2 was 0.60 (95% CI: 0.58-0.62). To reach a higher specificity of 99.0% (95% CI: 98.8-99.3%, and with sensitivity of 37.5%, 95% CI: 34.5-40.5%), a HCT-ALB value of 10.25 was recommended as the standard for diagnosis of severe infection.
The HCT-ALB value was increased in patients with infectious disease. The measurement of the HCT-ALB value (> 10.25) might be useful in the fast diagnosis of infectious disease.
在临床实践中，已观察到严重感染患者的血细胞比容（HCT）和血清白蛋白（ALB）水平会发生变化。本研究旨在评估HCT与ALB水平差值（HCT-ALB）是否可作为快速诊断严重感染的额外生物标志物。
这是一项回顾性病例对照研究，纳入了患有严重感染的成年患者、非感染性疾病患者和健康个体。2012年1月至2018年1月期间，在中国云南省共招募了7117名个体，并将其分为三组：1033例严重感染患者（第1组）；1081例非感染性疾病患者（第2组）；以及来自普通人群的5003名健康个体（第3组）。通过受试者工作特征（ROC）曲线分析确定严重感染患者HCT-ALB的潜在诊断阈值。以第3组作为对照，绘制第1组或第2组中HCT-ALB值的ROC曲线。
各组的HCT-ALB值存在显著差异。我们发现，第1组的ROC曲线下面积（AUC）达到0.87（95%置信区间：0.86-0.89），而第2组的AUC为0.60（95%置信区间：0.58-0.62）。为达到99.0%的更高特异性（95%置信区间：98.8-99.3%，灵敏度为37.5%，95%置信区间：34.5-40.5%），建议将HCT-ALB值10.25作为严重感染的诊断标准。
传染病患者的HCT-ALB值升高。测量HCT-ALB值（>10.25）可能有助于传染病的快速诊断。
